IDAHO – Idahoans may weigh in on the state’s transition to managing Medicaid through a private, third-party company.
The Idaho Legislature during the 2025 session approved House Bill 345, which moved oversight of Idaho’s entire Medicaid program to a managed care organization, added work requirements for some people, and required cost sharing of services for participants, among other sweeping changes.
Idaho governor signs bill to privatize management, add work requirements to Medicaid program
The Idaho Department of Health and Welfare is seeking public comment through a statewide survey that’s open through Dec. 31, according to a press release from the agency. The survey is aimed at Medicaid members, providers, managed care organizations, and pharmacy benefit managers.
“Our goal is to build a managed care system that truly reflects what Idahoans need from their health care,” Health and Welfare Director Juliet Charron said in the release. “We want to hear directly from the people we serve and from those who deliver care. Your voices will help us build a system that supports better access, strong outcomes, and long-term sustainability.”
The agency is also hosting in-person listening sessions around the state to hear from people currently using Medicaid, family members or caregivers of those on Medicaid, health care providers, and other community partners.
The listening session schedule is:
- Dec. 15, 2025 | Rexburg
- Jan. 6, 2026 | Caldwell
- Feb. 3, 2026 | Virtual only
- March 10, 2026 | Gooding
- April 7, 2026 | Boise
- May 26, 2026 | Coeur d’Alene
- May 28, 2026 | Lewiston
Idaho health officials have said it will take years to shift Idaho’s Medicaid program to managed care, the Idaho Capital Sun previously reported.
Idaho Medicaid to be privately managed in 2029, health officials expect
Many of Idaho’s Medicaid services had been provided what’s called a “fee-for-service” model, by which health care providers give the care to participants and then get reimbursed by Medicaid. Around 256,000 Idahoans use Medicaid services, according to numbers reported in September by Health and Welfare.
The state briefly went to a new model in which services overseen by local doctor-led organizations, in a unique-to-Idaho system called value-based care, which is expected to end in 2026.
Under managed care, a private contractor, or MCO, will oversee all services, such as doctor visits, prescriptions and hospital stays.
The work requirements under the new program will affect patients in Medicaid expansion, a program approved by Idaho voters in 2018 to open eligibility to those who fell in the gap between earning too much for traditional Medicaid and not enough to qualify for federal premium assistance to afford private health care through the state marketplace.
As of September, there were 89,881 people using Medicaid expansion services in Idaho.
More information on the survey, listening sessions and the change to managed care can be found at healthandwelfare.idaho.gov/managedcare.
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